Autism Spectrum Disorder, or ASD, is a complex developmental and neurological condition that typically appears during the first three years of life. It affects brain function, particularly in the areas of social interaction and communication skills. Classic symptoms include delayed talking, lack of interest in playing with other children, not wanting to be held or cuddled and poor eye contact. There is no known cause for ASD, but both genetics and environment are believed to play a role.
The Centers for Disease Control and Prevention estimates 1 in every 59 American children has been identified with ASD. It is about four times more common in boys than in girls.
People with ASD often may repeat behaviors or have narrow, restricted interests. These types of behavior can affect eating habits and food choices, which can lead to the following health concerns.
- Limited food selection or strong food dislikes. Someone with autism may be sensitive to the taste, smell, color and texture of foods. They may limit or totally avoid some foods and even whole food groups. Dislikes may include strong flavored foods, fruits and vegetables or certain textures such as slippery or soft foods.
- Not eating enough food. Kids with autism may have difficulty focusing on one task for an extended period of time. It may be hard for a child to sit down and eat a meal from start to finish.
- Constipation. This problem may be caused by a child’s limited food choices, low physical activity levels or medications. It typically can be remedied by gradually increasing sources of dietary fiber, such as bran cereals and fruits and vegetables, along with plenty of fluids and regular physical activity.
- Medication interactions. Some stimulant medications used with autism can lower appetite. This can reduce the amount of food a child eats, which may affect growth. Other medications may increase appetite or affect the absorption of certain vitamins and minerals. If your child takes medication, ask your healthcare provider about possible side effects.
Caring for a child with ASD can be challenging on many levels, and healthful eating is no exception. For children with ASD, a nutritious, balanced eating plan can make a world of difference in their ability to learn, how they manage their emotions and how they process information. Because children with ASD often avoid certain foods or have restrictions on what they eat, as well as difficulty sitting through meal times, they may not be getting all the nutrients they need.
According to research, over 70% of children with autism have at least one co-existing physical or mental health condition, and 40% have two or more of them. Among children with autism:
- 30-61% have ADHD
- 11-40% have anxiety disorders
- 7% have depression
- Over 50% have chronic sleep problems
- 32% are overweight (2 to 5 year-olds)
- 16% are obese (2 to 5 year-olds)
In addition, kids with autism are 8 times more likely to have gastrointestinal issues compared to those who don’t have the condition. And among adults with ASD, 26% have depression and 4-35% have schizophrenia (compared to 1.1% of the general population).
All of these challenges and symptoms can range from mild to severe. And food can have an impact on severity.
THE FOOD YOU EAT MATTERS
It is important to realize that the food you eat is either medicine or it is poison. It is either helping your brain, body, and mind or hurting them. Here are the top 5 foods to avoid as they can make ASD and co-occurring condition symptoms
1. DAIRY
When casein (one of the proteins in dairy) mixes with stomach acid, it Dairy is also problematic because it is considered one of the most pro-inflammatory foods in the Standard American Diet. According to a growing body of evidence, including a 2018 study in Pharmaceuticals, inflammation is strongly associated with autism and is also commonly linked to immune system dysfunction. Avoiding anything that promotes inflammation is critical for anyone with autism. In our experience, when people with ASD removed dairy from their diet, they began talking more, their hyperactivity was reduced, and bowel problems were resolved.
2. GLUTEN
Research shows that gluten—a mixture of proteins found in grains such as wheat, barley, and rye—can increase systemic inflammation when ingested. In fact, your body can create antibodies to gluten which can fire up, or inflame, your brain. Gluten also decreases good bacteria in the gastrointestinal system, which is associated with an increased likelihood of feeling anxious, stressed, or depressed. The gut-brain connection in autism is real, according to findings in a 2019 study.
Gluten seems to particularly negatively affect the functioning of the cerebellum. Located at the back bottom of the brain, the cerebellum is involved with motor and thought coordination and is essential for processing complex information. Through the brain imaging work at Amen Clinics, we have discovered that those with ASD already often have decreased functioning of their cerebellum—consuming gluten can just make it much worse.Although the research on gluten-free diets is mixed, many parents of children with autism report seeing improvements in symptoms when they eliminate gluten from their child’s meals.
3. CORN
In the U.S., per capita consumption of corn products has risen from 28.4 pounds per year in 2000 to a whopping 35.2 pounds per year in 2019, according to Statist. Since 1972, corn has been the top pesticide-using crop in the nation, based on findings from the USDA. A growing body of research, including a 2013 study in the journal Entropy, suggests a potential link between exposure to the herbicide glyphosate and the risk of autism.
Additionally, corn has the most unhealthy fatty-acid profile (high in omega-6 fatty acids that promote inflammation, compared to omega-3 fatty acids that are anti-inflammatory) of any grain. Yes, you read that right, GRAIN. Corn is NOT a vegetable. Corn has been found to be a breeding ground for fungi, with a 2015 study identifying 46 fungal isolates derived from maize grains. There is simply nothing truly beneficial and many potentially harmful things that can come from eating corn
4. SUGAR
Not only is sugar pro-inflammatory, but it also increases erratic brain cell firing and it is very addictive. In addition, research appearing in Frontiers in Endocrinology found that people with ASD, like those with type 2 diabetes, have impaired glucose tolerance and excessive levels of insulin. Because of this, consuming sugar may magnify improper insulin signaling.
Research in Plos One also shows that children with autism who also suffer from gastrointestinal distress have poor metabolism of sugars. In these children, scientists found deficiencies in the levels of enzymes and transporters involved in the digestion of sugars.
Avoiding sugar and refined carbohydrates and increasing lean protein consumption can dramatically improve concentration and judgment, and decrease impulsiveness.
5. ARTIFICIAL INGREDIENTS
A 2019 study suggests that the spike in autism may be connected to the preservatives found in processed foods. Other research points to a possible link between autism symptoms and artificial ingredients in our food supply. Avoid all additives, preservatives, dyes and artificial colors, artificial flavorings, and artificial sweeteners. Although these things are not really “foods”, they are unfortunately in so many food products that we wanted to list them here.If you or a loved one has ASD, paying close attention to the foods being consumed is particularly important. For our patients with autism, we often recommend an elimination diet—eliminating gluten, dairy, sugar, corn, soy, and other categories of potentially allergenic foods for one month. Then add these back one at a time and be alert for reactions to them, which would indicate that your child should permanently avoid that food.Along with diet, other areas should also be investigated to uncover and address the challenges of ASD. Autism, as well as co-existing conditions such as anxiety, depression, and ADD/ADHD, can’t wait. The earlier a child gets treatment for ASD the more effective it will be,.
Make Mealtimes Routine
A child with ASD will have to work harder at mealtimes because a busy kitchen, bright lights and even the way the furniture is arranged all are potential stressors. Making meals as predictable and routine as possible can help. Serving meals at the same time every day is one of the simplest ways to reduce stress. In addition, think about what concessions you can make for easier mealtimes. If your child is sensitive to lights, try dimming them or consider candlelight with adult supervision. Let your child pick a favorite food to include at every meal. Or, let your child choose a favorite seat at the table.
Be Prepared for Pickiness
Many parents find their child’s sensitivity to tastes, colors, smells and textures the biggest barriers to a balanced eating plan. Getting your child to try new foods — especially those that are soft and slippery — may seem nearly impossible. You may find that your child avoids certain foods or even entire food groups. One of the easiest ways to approach sensory issues is to tackle them outside of the kitchen. Have your child visit the supermarket with you to choose a new food. When you get home, research it together on the internet to learn about where it grows. Then, decide together how to prepare it. When you are done, don’t worry if your child doesn’t want to eat it. Simply becoming familiar with new foods in a low-pressure, positive way eventually can help your child become a more flexible eater.
Seek Guidance for Special Diets
You may have heard that a gluten- or casein-free diet can improve symptoms of ASD. Gluten is a type of protein found in wheat, rye and barley. Casein is a protein found in milk. Proponents of the diet believe people with autism have a “leaky gut,” or intestine, which allows parts of gluten and casein to seep into the bloodstream and affect the brain and central nervous system. The belief is that this may lead to autism or magnify its symptoms. However, controlled scientific studies have not proven this to be true, so the research at this time does not support their use. Keep in mind that restrictive diets require careful planning to make sure your child’s nutrition needs are being met. Consult with a registered dietitian nutritionist before making any drastic changes to your child’s meal plan as there can be side effects and potential nutrient shortfalls when a gluten- or casein-free diet is self-prescribed.
Working With a Registered Dietitian Nutritionist
Most children, with or without autism, can be choosy and particular about the foods they eat. A registered dietitian nutritionist can identify any nutritional risks based on how your child eats, answer your questions about the effectiveness and safety of nutrition therapies and supplements advertised for autism and help guide your child on how to eat well and live healthfully.
What Works Improve digestion
Many parents of autistic children report that their child received repeated or prolonged courses of antibiotic drugs for ear or other respiratory infections during their first year, before the diagnosis of autism. Broad-spectrum antibiotics kill good as well as bad bacteria in the gut, and this may be why autistic children commonly have bowel irregularities.
So if your child has autism, restoring a healthy gut is vital. You can start simply, by supplementing digestive enzymes, and giving probiotics to restore the balance of gut bacteria. Both measures help heal the digestive tract and promote normal absorption, and have produced positive clinical results in autistic children.
Take a probiotic: key to digestion is having balanced gut ecology. This means plenty of beneficial gut flora and lower levels of the non-beneficial strains. Since many children’s gut flora becomes imbalanced due to lack of breast-feeding or antibiotic use, it is usually necessary to supplement probiotics – beneficial gut bacteria. The most important strains are Lactobacillus Acidophilus and Bifidobacteria.
Supplement with digestive enzymes: Digestive enzymes provide assistance by helping to break down food making the nutrients more available for absorption and relieving the strain on the digestive system while it recovers. The amino acid glutamine is an important gut healing nutrient but may be contraindicated in autism because some autistics have protein deamination problems leading to production of ammonia which doesn’t mix well with glutamine.
Balance blood sugar
There is much overlap between ADH/hyperactivity and autism, so for autistic children who show signs of hyperactivity, improving blood sugar balance is a must.
Dietary studies consistently reveal that hyperactive children eat more sugar than other children4. Other research has confirmed that the problem is not sugar itself but the forms it comes in, the absence of a well-balanced diet overall, and abnormal glucose metabolism. A study of 265 hyperactive children found that more than three-quarters of them displayed abnormal glucose tolerance, – that is, their bodies were less able to handle sugar intake and maintain balanced blood sugar levels.
In any case, when a child is regularly snacking on refined carbohydrates, sweets, chocolate, fizzy drinks, juices and little or no fiber to slow the glucose absorption, the levels of glucose in their blood will seesaw continually and trigger wild fluctuations in their levels of activity, concentration, focus and behavior. These, of course, will not help any child’s brain function.
Cut out sugar and all sources of sugar. Eat only unrefined carbohydrates and ensure these are combined with protein and plenty of fiber to further slow the sugar release. Avoid stimulants, even apparently ‘natural’ ones. Increase omega 3 fats.
Deficiencies in essential fats are common in people with autism. Research by Dr. Gordon Bell at Stirling University has shown that some autistic children have an enzymatic defect that removes essential fats from brain cell membranes more quickly than it should. This means that an autistic child is likely to need a higher intake of essential fats than the average. And it has been found that supplementing EPA, which can slow the activity of the defective enzyme, has clinically improved behavior, mood, imagination, spontaneous speech, sleep patterns and focus of autistic children.
Eat fish at least twice a week, seeds on most days and supplementing omega 3 fish oils. Look for a supplement that contains EPA, DHA and GLA.
The best fish for EPA, the type of omega 3 fat that’s been most thoroughly researched are: mackerel (1,400mg per 100g/3oz), herring/kipper (1,000mg), sardines (1,000mg), fresh (not tinned) tuna (900mg), anchovy (900mg), salmon(800mg), trout (500mg). Tuna, being high in mercury is best eaten not more than twice a month.
The best seeds are flax seeds and pumpkin seeds. Flax seeds are so small they are best ground and sprinkled on cereal. Alternatively, use flax seed oil, for example in salad dressings. While technically providing omega 3 only about 5% of the type of omega 3 in these seeds is converted in your body into EPA.
Increase vitamins and minerals
Still others have, however, failed to confirm positive outcomes with certain nutrients. For example, a French study of 60 autistic children found they improved significantly on a combination of vitamin B6 and magnesium, but not when either nutrient was supplemented alone11. This study shows how important it is to get the balance of these nutrients right. It’s likely to be different for each child
Eat a diet rich in whole foods such as fresh fruit and vegetables, seeds, nuts and whole grains is naturally higher in vitamins and minerals. Avoid processed foods that have had many nutrients removed.
Avoid food allergies
One of the most significant contributing factors in autism appears to be undesirable foods and chemicals that often reach the brain via the bloodstream because of faulty digestion and absorption. Much of the impetus for recognizing the importance of dietary intervention has come from parents who’ve noticed vast improvements in their children after changing their diets.
The strongest direct evidence of foods linked to autism involves wheat and dairy, and the specific proteins they contain – namely, gluten and casein. These are difficult to digest and, especially if introduced too early in life, may result in an allergy. Fragments of these proteins, called peptides, can have big impacts in the brain. They can act directly in the brain by mimicking the body’s own natural opioids (such as the endorphins), and they can disable the enzymes that would break down these naturally occurring compounds.
In either case, the consequence is an increase in opioid activity, leading to many symptoms we describe as autism. Researchers at the Autism Research Unit at Sunderland University have found increased levels of these peptides in the blood and urine of children with autism.
Exorphin peptides are derived from incompletely digested proteins, particularly food containing gluten and casein. One of these, called IAG and derived from gluten in wheat, has been detected in 80 per cent of autistic patients. So the first problem is the poor digestion of proteins. A lack of sufficient zinc and vitamin B6 could contribute to this, as both are essential for proper stomach acid production and protein digestion, yet are often deficient in autistic children with piroluria, as we mention above.
There are many anecdotal reports of dramatic improvements in children with autism from parents who removed casein (milk protein) and gluten (the protein in wheat, barley, rye and oats) from their diet. Dr. Robert Cade, professor of medicine and physiology at the University of Florida, has observed that as levels of peptides in the blood decrease, the symptoms of autism decrease. ‘If [levels of peptides] can be reduced to normal range,’ he says, ‘we typically see dramatic improvements.’
If you decide to go down this route with your child, you’ll need to take a go-slow approach. The Autism Research Unit at Sunderland University recommends a gradual withdrawal of foods, waiting three weeks after the removal of dairy foods (casein) before removing wheat, oats, barley and rye (gluten) from the diet. Initially, your child may go through ‘withdrawal’ and their symptoms may get worse for a bit.
Keep a food diary and note your child’s behaviors and symptoms alongside all the foods they’re eating. This can help to identify which of the usual suspects they are sensitive to – citrus fruits, chocolate, artificial food colorings, salicylates, eggs, tomatoes, avocados, red peppers, soya and corn. But remember, most of the foods in this list contain valuable nutrients, too, so you’ll have to ensure that they are replaced rather than just removed. This entire process is best done under the guidance of a nutritional therapist.
Consider testing your child for IgE and IgG food allergies and avoid those foods to which they test allergic. Alternatively, consider pursuing a wheat and dairy free diet which has proven helpful for some, but not all, autistic children. However we recommend you do so under medical supervision, or supervision of a dietician or nutritional therapist to ensure that suitable replacement foods are included that ensure your child achieves optimal nutrition.
O.Ahmadpoor
IMUTISM Chief Operation Officer
May 2020
REFRENCE:
1.AUTISM SOCIETY CANADA
2.AUTISM SPRAK CANADA
3.AUTISM AND NUTRATION
4.NATIONAL AUTISTIC SOCIETY
5.AUTISM SOCIETY America
6. AUTISM SOCIETY IRAN
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